Hypothyroidism Flashcards
Deficiency of the thyroid hormones
Hypothyroidism
Hypothyroidism is common in _______ between ______ yrs old; incidence rises after age ___
Women; 40-60; 50
Basic Concepts of Hypothyroidism
a. Decrease metabolic rate: ⬇️T3
b. Decrease body heat production: ⬇️T4
c. Hypercalcemia: ⬇️Thyrocalcitonin
Causes of hypothyroidism (ARAT)
a. Autoimmune disorders
b. Radioactive iodine
c. Antithyroid drugs
d. Thyroidectomy
Hypothyroidism in adults; nonpitting edema in the connective tissue throughout the body
Myxedema
Signs of myxedema (PEH)
a. Puffy face
b. Enlarged toes
c. Hoarse voice
Hypothyroidism in children
Cretinism
Cretinism is the result of water retention in mucoprotein deposits in the interstitial spaces known as ____________________
Hydrophilic proteoglycans
Caused by congenital defects in the gland, loss of thyroids tissue following surgery or radiation, antithyroid medications, thyroiditis
Primary hypothyroidism
Another cause of primary hypothyroidism
Amiodarone (Codarone)
Results from pituitary TSH deficiency
Secondary Hypothyroidism
Initial sign of hypothyroidism
Fatigue
Manifestations of hypothyroidism
a. Goiter
b. Anorexia
c. Edema
d. Weight gain
e. Constipation
f. Dry skin
g. Pruritus
h. Dyspnea
i. Hoarseness
j. Muscle stiffness
k. Decreased sense of taste and smell
l. Menstrual disorders
m. Anemias
n. Cardiac enlargement
Abnormalities in lipid metabolism with elevated serum cholesterol and triglyceride
Atherosclerosis
Due to decreased renal blood flow and glomerular filtration rate that reduces the kidney’s ability to excrete water
Hyponatremia
Thyroid Preparations
a. Levothyrocine Sodium (T4), Levoxyl, Levothyroid, Synthroid
b. Liothyrobine Sodium (T3), Cytomel
c. Thyrolar, Thycar (Thyroid)
Treatment of choice of hypothyroidism
Levothyroxine
Effects of Levothyroxine
Increases CO, body temp, and oxygen consumption
When is levothyroxine given?
1 hour before meals or 2 hours after meals
What should you take before administering levothyroxine?
Apical pulse (<60 rebound tachycardia)
Effect of anticoagulant drugs: WOF?
Bleeding
Effect of digitalis:
Toxicity
Monitor for symptoms of?
Coronary insufficiency
a. Chest pain
b. Dyspnea
c. Tachycardia
Life threatening complication of longstanding untreated hypothyroidism usually triggered by an acute illness or trauma
Myxedema Coma
Occurrence and incidence of myxedema coma
a. Rare
b. Winter months
c. Failure to take thyroid replacement medications
Characteristics (severe metabolic disorders)
a. Hypoglycemia
b. Hypotension
c. Hyponatremia
d. Hypothermia
e. Lactic Acidosis
f. Bradycardia
g. Respiratory Failure
h. Coma
i. ALL VITAL SIGNS ARE PROFOUNDLY DEPRESSED
Myxedema coma management
a. Maintain patent airway
b. Administer IV fluids and Synthroid/IV as prescribed
c. Administer glucose/IV as ordered
d. Monitor client’s temperature. Keep client warm.
e. Monitor BP. Manage hypotension.
f. Monitor LOC
g. Monitor electrolyte and glucose levels
